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超声联合微泡增强阿米卡星在机械通气兔肺不张模型中的扩散

Enhanced Amikacin Diffusion With Ultrasound and Microbubbles in a Mechanically Ventilated Condensed Lung Rabbit Model.

作者信息

Espitalier Fabien, Darrouzain François, Escoffre Jean-Michel, Ternant David, Piver Eric, Bouakaz Ayache, Remerand Francis

机构信息

UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.

Pôle Anesthésie Réanimations, Hôpital Trousseau, CHRU de Tours, Tours, France.

出版信息

Front Pharmacol. 2020 Jan 16;10:1562. doi: 10.3389/fphar.2019.01562. eCollection 2019.

Abstract

The poor diffusion of intravenous antibiotics in lung tissue makes nosocomial pneumonia challenging to treat, notably in critical patients under mechanical ventilation. The combination of ultrasound and microbubbles (USMB) is an emerging method for non-invasive and targeted enhancement of uptake of various drugs in several organs. This study aims to evaluate if USMB may increase amikacin concentration in condensed lung tissues in a mechanically ventilated rabbit model. When applied 60 or 160 min after the beginning of an intravenous amikacin infusion, USMB increased amikacin concentration in the condensed lung tissue by 1.33 ( = 0.025) or 1.56-fold ( = 0.028) respectively. When applied 70 min after the beginning of an intravenous amikacin infusion, USMB increased amikacin concentration in the muscle tissue by 2.52 ( = 0.025). In conclusion, this study demonstrates that USMB is a promising method for the targeted delivery of amikacin in mechanically ventilated condensed lung, thus opening new therapeutic fields against lung infections.

摘要

静脉注射抗生素在肺组织中的扩散较差,这使得医院获得性肺炎难以治疗,尤其是在接受机械通气的重症患者中。超声与微泡(USMB)相结合是一种新兴的方法,可在多个器官中无创且靶向地增强各种药物的摄取。本研究旨在评估USMB是否可提高机械通气兔模型中肺实变组织中的阿米卡星浓度。在静脉输注阿米卡星开始后60或160分钟应用USMB时,肺实变组织中的阿米卡星浓度分别增加了1.33倍(P = 0.025)或1.56倍(P = 0.028)。在静脉输注阿米卡星开始后70分钟应用USMB时,肌肉组织中的阿米卡星浓度增加了2.52倍(P = 0.025)。总之,本研究表明,USMB是在机械通气的肺实变组织中靶向递送阿米卡星的一种有前景的方法,从而为对抗肺部感染开辟了新的治疗领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95a9/6976529/0e39e5b6dcf0/fphar-10-01562-g001.jpg

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